1
|
Romano VC, Lima NTDMB, Jabour VA, Del Guerra GC, Silvério PRB, Garcia RG, Sameshima YT, Francisco Neto MJ, de Queiroz MRG. Lessons from the pandemic and the value of a structured system of ultrasonographic findings in the diagnosis of COVID-19 pulmonary manifestations. EINSTEIN-SAO PAULO 2024; 22:eAE0780. [PMID: 38865568 PMCID: PMC11155724 DOI: 10.31744/einstein_journal/2024ae0780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/05/2023] [Indexed: 06/14/2024] Open
Abstract
Implementing a structured COVID-19 lung ultrasound system, using COVID-RADS standardization. This case series exams revealed correlations between ultrasonographic and tomographic findings. Ventilatory assessments showed that higher categories required second-line oxygen. This replicable tool will aid in screening and predicting disease severity beyond the pandemic. OBJECTIVE We aimed to share our experience in implementing a structured system for COVID-19 lung findings, elucidating key aspects of the lung ultrasound score to facilitate its standardized clinical use beyond the pandemic scenario. METHODS Using a scoring system to classify the extent of lung involvement, we retrospectively analyzed the ultrasound reports performed in our institution according to COVID-RADS standardization. RESULTS The study included 69 thoracic ultrasound exams, with 27 following the protocol. The majority of patients were female (52%), with ages ranging from 1 to 96 years and an average of 56 years. Classification according to COVID-RADS was as follows: 11.1% in category 0, 37% in category 1, 44.4% in category 2, and 7.4% in category 3. Ground-glass opacities on tomography correlated with higher COVID-RADS scores (categories 2 and 3) in 82% of cases. Ventilatory assessment revealed that 50% of cases in higher COVID-RADS categories (2 and 3) required second-line oxygen supplementation, while none of the cases in lower categories (0 and 1) utilized this support. CONCLUSION Lung ultrasound has been widely utilized as a diagnostic tool owing to its availability and simplicity of application. In the context of the pandemic emergency, a pressing need for a focused and easily applicable assessment arose. The structured reporting system, incorporating ultrasound findings for stratification, demonstrated ease of replicability. This system stands as a crucial tool for screening, predicting severity, and aiding in medical decisions, even in a non-pandemic context. Lung ultrasound enables precise diagnosis and ongoing monitoring of the disease. Ultrasound is an effective tool for assessing pulmonary findings in COVID-19. Structured reports enhance communication and are easily reproducible.
Collapse
Affiliation(s)
- Vítor Carminatti Romano
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | - Victor Arantes Jabour
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | | | - Rodrigo Gobbo Garcia
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Yoshino Tamaki Sameshima
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Miguel José Francisco Neto
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | |
Collapse
|
2
|
Bediwy AS, Al-Biltagi M, Nazeer JA, Saeed NK. Chest ultrasound in neonates: What neonatologists should know. Artif Intell Med Imaging 2022; 3:8-20. [DOI: 10.35711/aimi.v3.i1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/12/2022] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
For many years, ultrasound was thought to have no indications in pulmonary imaging because lungs are filled with air, creating no acoustic mismatch, as encountered by ultrasound wave beam. Lung ultrasound (LUS) was started in adult critical care settings to detect pleural effusion and acquired more indications over time. In the neonatal intensive care unit (NICU), the use of chest ultrasound has gained more attention during the last two decades. Being a radiation-free, bedside, rapid, and handy tool, LUS started to replace chest X-rays in NICU. Using LUS depends upon understanding the nature of normal lungs and the changes induced by different diseases. With the help of LUS, an experienced neonatologist can detect many of the respiratory problems so fast that interventional therapy can be introduced as early as possible. LUS can diagnose pleural effusion, pneumothorax, pneumonia, transient tachypnoea of the newborn, respiratory distress syndrome, pulmonary atelectasis, meconium aspiration syndrome, bronchopulmonary dysplasia, and some other disorders with very high accuracy. LUS will be helpful in initial diagnosis, follow-up, and predicting the need for further procedures such as mechanical ventilation, diuretic therapy, surfactant therapy, etc. There are some limitations to using LUS in some respiratory disorders such as bullae, interstitial emphysema, and other conditions. This review will highlight the importance of LUS, its uses, and limitations.
Collapse
Affiliation(s)
- Adel Salah Bediwy
- Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta 31511, Algharbia, Egypt
- Department of Pulmonology, University Medical Center, Arabian Gulf University, Manama 26671, Manama, Bahrain
| | - Mohammed Al-Biltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Algharbia, Egypt
- Department of Pediatrics, University Medical Center, Arabian Gulf University, Manama 26671, Manama, Bahrain
| | - Jameel Ahmed Nazeer
- Department of Radiology, University Medical center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
| | - Nermin Kamal Saeed
- Medical Microbiology Section, Pathology Department, Salmaniya Medical Complex , Ministry of Health, Kingdom of Bahrain , Manama 12, Manama, Bahrain
- Microbiology Section, Pathology Department, Irish Royal College of Surgeon, Bahrain, Busaiteen 15503, Muharraq, Bahrain
| |
Collapse
|
3
|
Pierro M, Chioma R, Ciarmoli E, Villani P, Storti E, Copetti R. Lung ultrasound guided pulmonary recruitment during mechanical ventilation in neonates: A case series. J Neonatal Perinatal Med 2021; 15:357-365. [PMID: 34151867 DOI: 10.3233/npm-210722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recently, the first report of lung ultrasound (LUS) guided recruitment during open lung ventilation in neonates has been published. LUS guided recruitment can change the approach to open lung ventilation, which is currently performed without any measure of lung function/lung expansion in the neonatal population. METHODS We included all the newborn infants that underwent a LUS-guided recruitment maneuver during mechanical ventilation as a rescue attempt for an extremely severe respiratory condition with oxygen saturation/fraction of inspired oxygen (SpO2/FIO2) ratio below 130 or the inability to wean off mechanical ventilation. RESULTS We report a case series describing 4 LUS guided recruitment maneuvers, underlying crucial aspects of this technique that can improve the effectiveness of the procedure. In particular, we describe a novel pattern (the S-pattern) that allows us to distinguish the recruitable from the unrecruitable lung and guide the pressure titration phase. Additionally, we describe the optimal LUS-guided patient positioning. CONCLUSIONS We believe that the inclusion of specifications regarding patient positioning and the S-pattern in the LUS-guided protocol may be beneficial for the success of the procedure.
Collapse
Affiliation(s)
- M Pierro
- Neonatal and Paediatric Intensive Care Unit, M. Bufalini Hospital, AUSL Romagna, Cesena, Italy.,Department of Mother's and Child's Health, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - R Chioma
- Department of Mother's and Child's Health, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.,Dipartimento Universitario Scienze della Vita e Sanitá Pubblica, Unitá Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Universitá Cattolica del Sacro Cuore, Rome, Italy
| | - E Ciarmoli
- Department of Mother's and Child's Health, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.,Department of Pediatrics, ASST Vimercate, Vimercate Hospital, Vimercate, Italy
| | - P Villani
- Department of Critical Care, Maggiore Hospital, Lodi, Lodi, Italy
| | - E Storti
- Department of Critical Care, Maggiore Hospital, Lodi, Lodi, Italy
| | - R Copetti
- Emergency Department, Latisana General Hospital, Udine, Italy
| |
Collapse
|
4
|
Potter SK, Griksaitis MJ. The role of point-of-care ultrasound in pediatric acute respiratory distress syndrome: emerging evidence for its use. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:507. [PMID: 31728360 DOI: 10.21037/atm.2019.07.76] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pediatric acute respiratory distress syndrome (PARDS) remains an important cause of significant morbidity and mortality. The 2015 PALICC definition of PARDS requires chest imaging to diagnose the presence of new pulmonary infiltrate(s). Traditionally chest radiography or computerised tomography have been used. However, these carry the limitations of exposure to ionizing radiation, need to transfer the critically unwell child, lag-time with clinical correlation and lack of immediate results. The use of point of care ultrasound (POCUS) has been well established in adult emergency medicine and critical care. Furthermore, the adult literature clearly demonstrates that lung POCUS is a safe and validated tool, which is highly sensitive and specific when compared to chest radiography for differentiating the causes of respiratory failure, including ARDS. Whilst pediatric specific data is limited, it has been shown that the signs seen in adults are reproducible in critically ill neonates and children. Furthermore, the numerous benefits of POCUS in the paediatric setting are compelling and include lack of ionizing radiation, immediate feedback, promoting time at the bedside of the critically unwell child, and ease of serial assessments. This review article presents the emerging evidence demonstrating that lung POCUS can be used not only to support the diagnosis of pediatric ARDS, but also to assess for complications, monitor progression and thus guide management. We hope it will stimulate much needed collaborative research into this exciting field of imaging and its applications to PARDS and beyond.
Collapse
Affiliation(s)
- Samantha K Potter
- Pediatric Intensive Care Unit, Southampton Children's Hospital, Southampton, UK
| | - Michael J Griksaitis
- Pediatric Intensive Care Unit, Southampton Children's Hospital, Southampton, UK.,Faculty of Medicine, University of Southampton, Southampton, UK
| |
Collapse
|
5
|
Ultrasound-Targeted Lung Recruitment: Process Improvement for Ventilating the Critically Ill Child. Pediatr Crit Care Med 2019; 20:493-494. [PMID: 31058788 DOI: 10.1097/pcc.0000000000001901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Tripathi S, Ganatra H, Martinez E, Mannaa M, Peters J. Accuracy and reliability of bedside thoracic ultrasound in detecting pulmonary pathology in a heterogeneous pediatric intensive care unit population. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:63-70. [PMID: 30393878 DOI: 10.1002/jcu.22657] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/23/2018] [Accepted: 09/28/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE This study was designed to access sensitivity and specificity of detection of lung abnormalities by the ultrasound (US) done by PICU providers of varying levels of experience compared to CXR and to assess the inter-rater reliability in the interpretation of the USG findings. METHODS Up to three US examinations were performed on patients meeting eligibility criteria. US examinations were reported by the operator and remotely by an expert reader. Both operator and readers interpretation were correlated with CXR read by an independent pulmonologist. RESULTS One hundred and thirty-five US examinations were performed on 91 patients over 9 months. Overall agreement between the operator and reader of the US was 0.53 (0.38-0.68). The agreement was highest with an expert-expert pair (0.75) and lowest with a novice-expert pair (0.27). Sensitivity and specificity of thoracic US to detect pulmonary abnormalities showed a high sensitivity by the operator (82.5%) compared to the reader (63.4%). Specificity was 25% and 42.8%, respectively. US was overall highly sensitive to detect pneumonia (96.4%) with a 100% PPV, but only modest for bronchiolitis. CONCLUSIONS Lungs US is a rapid and sensitive bedside tool to assess lung consolidation in children in ICU. It, however, has low negative predictive values, and negative US examinations cannot rule out lung pathology.
Collapse
Affiliation(s)
- Sandeep Tripathi
- Division of Critical Care Medicine, Children's Hospital of Illinois, Peoria, Illinois
| | - Hammad Ganatra
- Division of Critical Care Medicine, Kansas University Medical Center, Kansas City, Missouri
| | - Edmundo Martinez
- Division of Critical Care, Cardinal Glennon Children's Hospital, St Louis, Missouri
| | - Mohannad Mannaa
- Division of Pediatric Pulmonology, Children's Hospital of Illinois, Peoria, Illinois
| | - Joe Peters
- Department of Emergency Medicine, OSF St Francis Medical Center, Peoria, Illinois
| |
Collapse
|
7
|
Zhou Y, Fan Q, Cavus O, Zhang X. Lung ultrasound: Predictor of acute respiratory distress syndrome in intensive care unit patients. Saudi J Anaesth 2018; 12:457-461. [PMID: 30100847 PMCID: PMC6044168 DOI: 10.4103/sja.sja_73_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PURPOSE The purpose of the study was to review and summarize current literature concerning the validation and application of lung ultrasound (LUS) in critically ill patients with acute respiratory distress syndrome (ARDS). MATERIALS AND METHODS An extensive literature search was conducted using PubMed, Cochrane Review, Google Scholar, and Ohio State University Link based on the question if LUS should be considered a reliable investigational technique for ARDS diagnosis, treatment, and prognosis in pediatric and adult population. RESULTS LUS has been successfully validated for facilitating early diagnosis and diagnosis of simultaneous lung conditions, predicting lung recruitment treatment effect, and evaluating the prognosis in ARDS patients. Whether lung US is a useful tool in the prediction of prone position and oxygenation response in patients with ARDS is conflicting. CONCLUSIONS LUS is a noninvasive, radiation-free, cheap, and easy to perform tool for critically ill patients with ARDS and might be a promising technique used in the Intensive Care Unit for ARDS management.
Collapse
Affiliation(s)
- Ying Zhou
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qianqian Fan
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Omer Cavus
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Xuezheng Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
8
|
Liang HY, Liang XW, Chen ZY, Tan XH, Yang HH, Liao JY, Cai K, Yu JS. Ultrasound in neonatal lung disease. Quant Imaging Med Surg 2018; 8:535-546. [PMID: 30050788 DOI: 10.21037/qims.2018.06.01] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Lung diseases in neonates can be life-threatening condition and may result in respiratory failure and death. Chest X-ray is a traditional diagnostic technique that results in radiation exposure to patients. Lung ultrasound is a user-friendly imaging technique that has been increasingly used in clinical practice in recent years and presents the advantages of real-time imaging and without radiation. Here we review the sonographic appearances of common neonatal lung diseases and present demonstration of typical cases.
Collapse
Affiliation(s)
- Hui-Ying Liang
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Xiao-Wen Liang
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Zhi-Yi Chen
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Xiao-Hua Tan
- Department of Neonatology and Neonatal Intensive Care Unit, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Hui-Hui Yang
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Jian-Yi Liao
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Kuan Cai
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Jin-Sui Yu
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| |
Collapse
|
9
|
Fonseca EKUN, Castro ADAE, Sameshima YT. Pneumothorax: between the beach and the stratosphere. J Bras Pneumol 2018; 43:324-325. [PMID: 29365008 PMCID: PMC5687973 DOI: 10.1590/s1806-37562017000000079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Adham do Amaral E Castro
- . Departamento de Diagnóstico por Imagem, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
| | - Yoshino Tamaki Sameshima
- . Departamento de Diagnóstico por Imagem, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
| |
Collapse
|
10
|
Tang KQ, Yang SL, Zhang B, Liu HX, Ye DY, Zhang HZ, Ma S. Ultrasonic monitoring in the assessment of pulmonary recruitment and the best positive end-expiratory pressure. Medicine (Baltimore) 2017; 96:e8168. [PMID: 28953669 PMCID: PMC5626312 DOI: 10.1097/md.0000000000008168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 08/30/2017] [Accepted: 09/01/2017] [Indexed: 01/05/2023] Open
Abstract
The aim of this study was to explore the clinical value of ultrasonic monitoring in the assessment of pulmonary recruitment and the best positive end-expiratory pressure (PEEP).Between January 2015 and June 2017, 40 patients with acute respiratory distress syndrome in our hospital were randomly divided into 2 groups: ultrasound group (ULS group; n = 20) and oxygenation group (OXY group; n = 20). The PEEP incremental method was used to perform recruitment maneuvers. Ultrasound scoring and the oxygenation method were used to evaluate the pulmonary recruitment endpoint. The best PEEP was chosen by ultrasound scoring and the oxygenation method after achieving the pulmonary recruitment endpoint and sustaining it for 15 minutes.The oxygenation index, PEEP, peak airway pressure (Ppeak), mean airway pressure (Pmean), and dynamic compliance (Cdyn) in the OXY group were significantly lower than those in the ULS group (P < .05) at the pulmonary recruitment endpoint; however, there was no statistical significance in the mean arterial blood pressure (MAP) or heart rate (HR) (P > .05). The best PEEPs in the OXY and ULS groups were 13.1 ± 3.1 and 15.7 ± 4.2 cmH2O, respectively, with a significant difference between the 2 groups (t = 2.227, P = .016). Compared with the basal state, the Cdyn, oxygenation index, Pmean, and Ppeak in both groups significantly increased after pulmonary recruitment (P < .05). Furthermore, the Cdyn and oxygenation index in the ULS group were significantly higher than those in the OXY group after pulmonary recruitment (P < .05). The HR in both groups significantly increased, and the MAP significantly decreased. Two hours after recruitment, the HR and MAP returned to near basal levels without a significant difference between the 2 groups (P > .05).Lung ultrasound can be used to detect the endpoint of lung recruitment and the best PEEP, with good effects on lung compliance and oxygenation improvement.
Collapse
Affiliation(s)
- Ke-Qiang Tang
- Emergency Critical Care Division, Shanghai Songjiang District Central Hospital, Songjiang Branch of the Affiliated First People's Hospital of Shanghai Jiao Tong University
| | - Shao-Ling Yang
- Department of Cardiac Vascular Ultrasound, Shanghai Fengxian District Central Hospital, Shanghai, China
| | - Bin Zhang
- Emergency Critical Care Division, Shanghai Songjiang District Central Hospital, Songjiang Branch of the Affiliated First People's Hospital of Shanghai Jiao Tong University
| | - Hong-Xiang Liu
- Emergency Critical Care Division, Shanghai Songjiang District Central Hospital, Songjiang Branch of the Affiliated First People's Hospital of Shanghai Jiao Tong University
| | - Dong-Ying Ye
- Emergency Critical Care Division, Shanghai Songjiang District Central Hospital, Songjiang Branch of the Affiliated First People's Hospital of Shanghai Jiao Tong University
| | - Hong-Ze Zhang
- Emergency Critical Care Division, Shanghai Songjiang District Central Hospital, Songjiang Branch of the Affiliated First People's Hospital of Shanghai Jiao Tong University
| | - Shuang Ma
- Emergency Critical Care Division, Shanghai Songjiang District Central Hospital, Songjiang Branch of the Affiliated First People's Hospital of Shanghai Jiao Tong University
| |
Collapse
|
11
|
Francisco MJ, Rahal A, Vieira FAC, Silva PSDD, Funari MBDG. Advances in lung ultrasound. EINSTEIN-SAO PAULO 2017; 14:443-448. [PMID: 27759836 PMCID: PMC5234763 DOI: 10.1590/s1679-45082016md3557] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 05/17/2016] [Indexed: 01/28/2023] Open
Abstract
Ultrasound examination of the chest has advanced in recent decades. This imaging modality is currently used to diagnose several pathological conditions and provides qualitative and quantitative information. Acoustic barriers represented by the aerated lungs and the bony framework of the chest generate well-described sonographic artifacts that can be used as diagnostic aids. The normal pleural line and A, B, C, E and Z lines (also known as false B lines) are artifacts with specific characteristics. Lung consolidation and pneumothorax sonographic patterns are also well established. Some scanning protocols have been used in patient management. The Blue, FALLS and C.A.U.S.E. protocols are examples of algorithms using artifact combinations to achieve accurate diagnoses. Combined chest ultrasonography and radiography are often sufficient to diagnose and manage lung and chest wall conditions. Chest ultrasonography is a highly valuable diagnostic tool for radiologists, emergency and intensive care physicians.
Collapse
Affiliation(s)
| | - Antonio Rahal
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | | | | |
Collapse
|
12
|
Kaiser Ururahy Nunes Fonseca E, do Amaral E Castro A, Sameshima YT. Emergency Thoracic US. Radiographics 2016; 36:2238. [PMID: 27831841 DOI: 10.1148/rg.2016160152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Adham do Amaral E Castro
- Department of Imaging, Hospital Israelita Albert Einstein, Av Albert Einstein 627, Sao Paulo, SP 05652-900, Brazil
| | - Yoshino Tamaki Sameshima
- Department of Imaging, Hospital Israelita Albert Einstein, Av Albert Einstein 627, Sao Paulo, SP 05652-900, Brazil
| |
Collapse
|
13
|
Song IK, Kim EH, Lee JH, Ro S, Kim HS, Kim JT. Effects of an alveolar recruitment manoeuvre guided by lung ultrasound on anaesthesia-induced atelectasis in infants: a randomised, controlled trial. Anaesthesia 2016; 72:214-222. [DOI: 10.1111/anae.13713] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2016] [Indexed: 01/06/2023]
Affiliation(s)
- I.-K. Song
- Department of Anesthesiology and Pain Medicine; Seoul National University Hospital; Seoul Korea
| | - E.-H. Kim
- Department of Anesthesiology and Pain Medicine; Seoul National University Hospital; Seoul Korea
| | - J.-H. Lee
- Department of Anesthesiology and Pain Medicine; Seoul National University Hospital; Seoul Korea
| | - S. Ro
- Department of Anesthesiology and Pain Medicine; Seoul National University Hospital; Seoul Korea
| | - H.-S. Kim
- Department of Anesthesiology and Pain Medicine; Seoul National University Hospital; Seoul Korea
| | - J.-T. Kim
- Department of Anesthesiology and Pain Medicine; Seoul National University Hospital; Seoul Korea
| |
Collapse
|
14
|
Donoso A, Arriagada D, Contreras D, Ulloa D, Neumann M. [Respiratory monitoring of pediatric patients in the Intensive Care Unit]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2016; 73:149-165. [PMID: 29421202 DOI: 10.1016/j.bmhimx.2016.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/29/2016] [Accepted: 02/02/2016] [Indexed: 06/08/2023] Open
Abstract
Respiratory monitoring plays an important role in the care of children with acute respiratory failure. Therefore, its proper use and correct interpretation (recognizing which signals and variables should be prioritized) should help to a better understanding of the pathophysiology of the disease and the effects of therapeutic interventions. In addition, ventilated patient monitoring, among other determinations, allows to evaluate various parameters of respiratory mechanics, know the status of the different components of the respiratory system and guide the adjustments of ventilatory therapy. In this update, the usefulness of several techniques of respiratory monitoring including conventional respiratory monitoring and more recent methods are described. Moreover, basic concepts of mechanical ventilation, their interpretation and how the appropriate analysis of the information obtained can cause an impact on the clinical management of the patient are defined.
Collapse
Affiliation(s)
| | | | - Dina Contreras
- Hospital Clínico Metropolitano La Florida, Santiago, Chile
| | - Daniela Ulloa
- Hospital Clínico Metropolitano La Florida, Santiago, Chile
| | - Megan Neumann
- Hospital Clínico Metropolitano La Florida, Santiago, Chile
| |
Collapse
|